Prescription and over-the-counter drugs can help you quit smoking.

If you want to quit but are struggling with the effects of nicotine withdrawal, you may find it helpful to use a nicotine replacement product (so-called nicotine replacement therapy, or NRT) or a prescription drug (non-nicotine containing).

Prescription Drugs to Help You Quit Smoking

There are a variety of doctor-prescribed drugs that may help you quit smoking. The drugs may be used along with some NRT products.

Speak with your doctor to find the best choice for you. The options approved by the Food and Drug Administration (FDA) include:

Bupropion

Bupropion (brand names are Wellbutrin, Zyban, or Aplenzin) does not contain nicotine.

Instead, it is a prescription antidepressant that reduces symptoms of nicotine withdrawal by acting on chemicals in your brain that help trigger nicotine cravings.

For the best results, you should start taking bupropion one to two weeks before you quit smoking. Your doctor may have you keep taking it for a few weeks after you fully quit smoking.

The usual dosage is one or two 150 milligram (mg) tablets per day.

This drug should not be taken if you have or have ever had:

Seizures

Heavy alcohol use

Cirrhosis

Serious head injury

Bipolar illness

Anorexia or bulimia

The most common side effects of bupropion include:

Dry mouth

Trouble sleeping

Tiredness

Irritability

Indigestion

Headaches

Varenicline

Varenicline (brand name Chantix) was developed specifically to help people stop smoking; it works by interfering with nicotine receptors in the brain.

It does this in two ways: it lessens the pleasure you get from smoking and it reduces the symptoms of nicotine withdrawal. Varenicline should be started a week before you quit smoking.

Varenicline is taken over a 12-week period at increasingly higher dosages.

Be aware that varenicline carries an FDA-required black-box warning because of use of the drug has been linked to depression, suicide ideation, and suicide.

People taking varenicline should be monitored for any kind of psychiatric symptoms, such as agitation, hostility, depressed mood, changes in behavior or thinking, or suicidal thoughts or behavior.

The most common side effects of varenicline include:

Headaches

Changes in taste

Nausea

Vomiting

Trouble sleeping

Gas

Other prescription drugs, such as nortriptyline (Pamelor) and clonidine (Catapres), are sometimes recommended for smokers who cannot use varenicline or bupropion.

Both of these are older drugs that may have significant side effects; talk to your doctor to decide if either of these are a good option for you when you’re ready to stop smoking

Over-the-Counter Nicotine Replacement Therapy Products

The Food and Drug Administration (FDA) has approved five types of nicotine replacement therapy (NRT) products.

You can use more than one type at a time, but if you do, speak with your doctor to make sure you are not getting too much nicotine at once. The five types of NRT products are:

Nicotine Patches: Patches are available in different strengths that last for 16 to 24 hours, and supply a measured dose of nicotine through your skin.

The right patch for you will depend on how many cigarettes you smoke daily, how long you have been smoking, and your body size. You’ll switch to lower-dose patches over the course of about eight weeks until you are completely weaned off of nicotine. The FDA has approved using the patch for a period of three to five months.

Nicotine Gum: Nicotine gum is a popular NRT choice because you can chew a piece whenever a craving hits and it give you something to do with your mouth, which can help keep you distracted and satisfied without lighting up — and it’s fast-acting.

The gum is available in two strengths. You should gradually cut back on the amount of gum you chew over the course of six to 12 weeks and the maximum recommended length of use is six months.

Nicotine lozenges: Nicotine lozenges are similar to nicotine gum in that you can pop one whenever a craving hits. Also, like the gum, they are available over-the-counter (OTC) and in two different strengths.

The best lozenge for you will depend on how long you have been smoking and how heavy a smoker you are. As with other NRT products, you’ll want to wean yourself off them over the course of several weeks. Lozenges should be used for 12 weeks at the most.

Nasal Sprays: Nasal sprays are another fast-acting NRT product; because the nicotine is absorbed through the nose it gets into your bloodstream quickly.

If you have asthma, allergies, nasal polyps, or sinus problems, nasal sprays may not be the ideal option for you.

Nicotine nasal spray is available by prescription only and the FDA recommends that the spray be used for no longer than six months.

Nicotine inhalers: If you are struggling with the habitual effects of quitting smoking, a nicotine inhaler may be your best option, because it is the most like smoking.

Inhalers look like a large cigarette with a cartridge in the mouthpiece, and you inhale the nicotine from the device. It’s available by prescription and is recommended for six months of use.

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